Goal: To provide Jeffrey M. Saland, MD with a mentored program for patient-oriented research resulting in his development as an independent physician-scientist with expertise in both nephrology and lipoprotein metabolism. Candidate: Dr. Saland is junior faculty in Pediatric Nephrology since July 2002. He completed the first year of the Mount Sinai School of Medicine K30 program while developing his interest in dyslipidemia and cardiovascular disease (CVD) associated with chronic kidney disease (CKD). Dr. Saland will obtain advanced training in lipoprotein physiology and vascular biology through graduate level courses at the Columbia University Institute of Human Nutrition. He will complete a Master's Degree in the Mount Sinai K30 program and gain knowledge of genomic investigation by teaming with experienced collaborators. Research: Approximately 8 million people in the U.S. have CKD. These individuals, particularly those with severe CKD, suffer premature and accelerated CVD. While dyslipidemia is common in this setting, its origins and pathological role remain unclear. This project will test the hypothesis that children and young adults with CKD develop impairment in the normal pathways of triglyceride-rich lipoprotein metabolism as part of an atherogenic metabolic syndrome that includes insulin resistance. Several approaches will be used to test this hypothesis: 1) Measure the rate of post-prandial triglyceride metabolism while assessing the influences of insulin resistance and severity of CKD;2) Assess the utility of vessel wall MRI to measure sub-clinical atherosclerotic plaque and its relation to dyslipidemia in young people with CKD;3) Extract useful measures from the array of techniques used in this project and develop them for future research or clinical purposes. Environment: Dr. Saland's development will be guided by experienced mentors, advanced by organized coursework in lipoprotein physiology and the conduct of clinical research, and supported with protected research time and designated space. Dr. Saland will uniquely benefit from the combined excellence of two General Clinical Research Centers operating in the dynamic academic environments of Mount Sinai, Columbia University, and an active New York lipid and vascular disease research community